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. 2024 Nov 7;14(22):2487.
doi: 10.3390/diagnostics14222487.

Comparative Safety Profiles and Usage Patterns of Iodinated Contrast Media in Medical Imaging

Yu Ri Shin  1 , Seo Yeon Youn  1 , Hokun Kim  1 , Ho Jong Chun  1 , Hwa Young Lee  2 , Hyo Joon Kim  3 , Soon Nam Oh  1
Affiliations

Comparative Safety Profiles and Usage Patterns of Iodinated Contrast Media in Medical Imaging

Yu Ri Shin et al. Diagnostics (Basel). .

Abstract

Objectives: This study aimed to analyze the usage patterns and hypersensitivity reaction (HSR) profiles of six nonionic iodinated contrast media (ICMs) used in computed tomography (CT) to enhance patient safety and inform evidence-based contrast agent selection.

Methods: We retrospectively reviewed 248,209 CT scans obtained between January 2020 and December 2022. Six ICMs (iomeprol, iohexol, ioversol, iopromide, iodixanol, and iobitridol) were compared on the basis of their usage rates, HSR incidence, and severity. This study also evaluated the impact of premedication protocol reinforcement and assessed the quarterly HSR rates.

Results: Among the 248,209 CT scans, 1603 (0.65%) were associated with HSRs. Most HSRs were mild (86.2%), with moderate (10.9%) and severe (2.9%) reactions being less common. Four ICMs were used as first-line agents and two ICMs were used as second-line agents. The second-line agents, iobitridol and iodixanol, exhibited 7-8 times higher HSR rates compared to the first-line agents. A modified premedication protocol implemented in mid-2022 significantly reduced the incidence of moderate HSRs (p = 0.0075). The quarterly analysis indicated a trend in higher HSR rates in the first quarter and a statistically significant increase in severe HSRs in the third quarter (p = 0.033).

Conclusions: These findings highlight the importance of tailored premedication protocols and a 7-8 times higher rate of HSR with second-line agents in contrast-enhanced imaging. Future research should focus on elucidating the mechanisms underlying these variations to further refine contrast agent selection and management strategies.

Keywords: X-ray computed; contrast media; incidence; premedication; tomography.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The overall incidence and severity of HSR according to the generic profile of ICMs.
Figure 2
Figure 2
Incidence and severity of HSR before (A) and after 1st quarter of 2021 (B).
Figure 3
Figure 3
Difference in HSR severity according to contrast agent.
Figure 4
Figure 4
(A). Difference in HSR severity according to contrast agent. (B) Quarterly variation in the HSR rate according to first- and second-line contrast agents.
See this image and copyright information in PMC

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